Active NPI
Quality Mental Health
- Mental Health Counselor
- Cheyenne, WY
National Provider Identifier
1467791293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC-455
- Legal business name
- QUALITY MENTAL HEALTH
- Practice address
- 4025 Rawlins St
Cheyenne, WY 82001-1900 - Phone
- (307) 426-4798
- Fax
- (307) 426-4799
- NPI assigned
- Feb 14, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bob Logan, LPC
- Title
- Owner/Licensed Professional Counsel
- Phone
- (307) 426-4798
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC-455 | WY | Primary |
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | LPC-455 | WY |
Addresses
Primary practice location
4025 Rawlins St
Cheyenne, WY 82001-1900
Mailing address
4025 Rawlins St
Cheyenne, WY 82001-1900
Phone (307) 426-4798
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16662500 | Medicaid | WY | |
| 310021 | Other | WY | BCBS OF WYOMING |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360800000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1360800000000",
"number": "1467791293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4025 RAWLINS ST",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820011900",
"telephone_number": "307-426-4798",
"fax_number": "307-426-4799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4025 RAWLINS ST",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820011900",
"telephone_number": "307-426-4798",
"fax_number": "307-426-4799"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "QUALITY MENTAL HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2013-02-14",
"last_updated": "2013-02-14",
"status": "A",
"authorized_official_last_name": "LOGAN",
"authorized_official_first_name": "BOB",
"authorized_official_title_or_position": "OWNER/LICENSED PROFESSIONAL COUNSEL",
"authorized_official_telephone_number": "307-426-4798",
"authorized_official_credential": "LPC"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "WY",
"license": "LPC-455",
"primary": true
},
{
"code": "261QR0405X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
"state": "WY",
"license": "LPC-455",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "16662500",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF WYOMING",
"identifier": "310021",
"state": "WY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cheyenne, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.